Objective To investigate the clinical value of fast track surgery (FTS) in perioperative management of laparoscopic cholecystectomy in the plateau.Methods The clinical data of 88 patients with gall stone who received laparoscopic cholecystectomy at the No.115 Central Hospital of PLA from March 2011 to July 2012 were retrospectively analyzed.All the patients were randomly divided into the control group (44 patients) and the observation group (44 patients).Patients in the control group received traditional perioperative treatment,while patients in the observation group received FTS treatment.Differences in the operation time,time to out-of-bed activity,time for recovery of bowel function,duration of postoperative hospital stay,medical treatment cost and incidence of complications between the 2 groups were compared.The measurement data were shown in x ± s,and analyzed using the t test,and the count data were analyzed using the chi-square test.Results The operation time of the control group and the observation group were (63 ± 19)minutes and (59 ± 21)minutes,with no significant difference between the 2 groups (t =-1.34,P ＞ 0.05).The time for out-of-bed activity,recovery of bowel function,duration of postoperative hospital stay and medical treatment cost were (25 ± 6) hours,(36 ± 9) hours,(5.6 ± 1.3) days,(10.8 ± 1.1) × 103 yuan in the control group,and (10 ± 4) hours,(23 ± 5) hours,(3.1 ± 1.3) days,(7.9 ± 1.3) × 103 yuan in the observation group,with significant differences between the 2 groups (t =-3.81,-3.67,-6.40,-4.08,P ＜ 0.05).The incidences of complications in the control group and the observation group were 4.5％ (2/44) and 2.3％ (1/44),respectively,with no significant difference between the 2 groups (x2=3.01,P ＞ 0.05).Conclusion FTS can promote the recovery of patients,decrease duration of hospital stay and medical treatment cost without increasing incidence of complication for patients who received laparoscopic cholecystectomy in the plateau.

It is reported in this article that ?-lipoprotein and partial ?_1-and X_2-globulin in scrum are apparently lower, but haptoglobin and ?-lipoprotein are apparently higher by polyacryamide gel clectrophoresis in 50 cases of uremi(?) patients, and that albumin and partial ?_1-and ?_2-globulin in scrum are apparently lower, but partial ?_2-globulin and ?-lipoproteinare apparently higher by polyacryamide gel clectrophoresis in 50 cases of nephrotic syndrome patients. The mechanism and clinical significance of these changes are discussed.

Objective The key points in the epithelial-mesenchymal transition ( EMT) procedure include the downregula-tion of epithelial protein (E cadherin) and the upregulation of cell activity and cell matrix generation .The aim of this study was to es-tablish a method for primary culture and identification of mouse renal tubular epithelial cells and to explore whether the activation of C3aR can induce epithelial-to-mesenchymal transition in mouse primary renal epithelial cells . Methods Murine renal tubular seg-ments were used for primary cell culture .Immunocytochemistry and immunofluorescence staining were used to identify the renal tubular epithelial cells.The experiment groups included control group , five different concentrations of C3aR agonist groups (0.1, 1, 100, 500, and 2000 ng/mL), and three different time-point groups.The mRNA levels of E-cadherin,α-smooth muscle actin (SMA) and colla-gen I in renal tubular epithelial cells were detected by Real-time PCR; the protein of E-cadherin, α-SMA were detected by Western blot.The cytoskeleton of epithelial cells was observed by phalloidin staining . Results Compared with the control group , the protein expression of E-cadherin deceased (0.950±0.901 vs 0.650±0.221) and the expression of α-SMA (1.380±0.062 vs 1.600±0.103) and collagen I increased in C3aR agonist group (500 ng/mL, after 48 hours) (P<0.05).In addition, the association between these changes and C3aR agonists was presented in a dose-and time-dependent man-ner, respectively.The cytoskeleton staining showed that treatment of renal tubular epithelial cells with C 3aR agonists induced the formation of actin stress fibers in a time-dependent manner . Conclusion The method for primary culture and identification of mouse renal tubular epithelial cells were successfully established .The activation of C3aR could induce epithelial-to-mesenchymal transition in mouse primary renal epithelial cells , which plays an essential role in the de-velopment of renal fibrosis .Moreover , this study indicated that C 3aR may become a new therapeutic target in kidney diseases .

AIM:To study the molecular mechanism of EGCG on inhibiting the growth of hepatic carcinoma. METHODS: The proliferation of hepatic cell line HepG2 cultured with different doses of EGCG was studied by MTT and suspension/adherence methods. The effect of EGCG on the expression of HIF-1?/VEGF at mRNA and protein levels in vitro and in vivo was evaluated by RT-PCR and Western blotting,respectively. The inhibition of EGCG on the growth of tumor implanted into athymic nude mice was also observed. RESULTS: The proliferation of hepatic cell line HepG2 was inhibited by EGCG in a dose-dependent manner. The expression of HIF-1?/VEGF was suppressed markedly by EGCG at protein level. However,the inhibitory effect of EGCG on the mRNA expression was only observed on VEGF,not on HIF-1?. In the animal experiment,the implanted tumor growth was inhibited by 39.8%?5.1%. CONCLUSION: EGCG suppresses the hepatic carcinoma cell growth,and interrupts the HIF-1?/VEGF signaling pathway significantly,indicating a fundamental mechanism of EGCG for inhibiting tumor growth.

Objective To evaluate radical gastrectomy combined with cholecystectomy for gastric cancer patients with concomitant gallbladder disease.Methods Clinical data of 702 gastric cancer patients undergoing radical gastrectomy (614 patients) only or combined with cholecystectomy during radical gastrectomy from October 2009 to September 2014 in our department was retrospectively analyzed.Results The operating time of patients with simultaneous cholecystectomy was(348 ± 111)min.the operating time of patients with radical gastrectomy only was (274 ± 89) min (t =3.812,P ＜ 0.05).Perioperative and postoperative complications,hospitalization expenses and 5-year survival rates were not statistically significant (P ＞ 0.05).Conclusions Radical gastrectomy with cholecystectomy for gastric cancer with gallbladder disease patients is safe and feasible.

AIM: To study the molecular mechanism of EGCG on inhibiting the growth of hepatic carcinoma. METHODS: The proliferation of hepatic cell line HepG2 cultured with different doses of EGCG was studied by MTT and suspension/adherence methods. The effect of EGCG on the expression of HIF-1α/VEGF at mRNA and protein levels in vitro and in vivo was evaluated by RT-PCR and Western blotting, respectively. The inhibition of EGCG on the growth of tumor implanted into athymic nude mice was also observed. RESULTS: The proliferation of hepatic cell line HepG2 was inhibited by EGCG in a dose-dependent manner. The expression of HIF-1α/VEGF was suppressed markedly by EGCG at protein level. However, the inhibitory effect of EGCG on the mRNA expression was only observed on VEGF, not on HIF-1α. In the animal experiment, the implanted tumor growth was inhibited by 39.8%±5.1%. CONCLUSION: EGCG suppresses the hepatic carcinoma cell growth, and interrupts the HIF-1α/VEGF signaling pathway significantly, indicating a fundamental mechanism of EGCG for inhibiting tumor growth.

Objective To summarize and analyze data of solid pseudopapillary tumor of pancreas (SPTP) in China,and investigate its epidemiology,clinical features,diagnosis and treatment.Methods Retrieval of Chinese Medical Current Contents and China Biology Medicine disc by the key words of solid pseudopapillary tumor of the pancreas,papillary cystic tumor of the pancreas,pancreatic papillary epithelial tumor,cystic solid tumor of pancreas and Frantz tumor were performed,and relevant literatures were included.Results A total of 1180 SPTP patients from 117 articles were involved.There were 1054 women and 126 men and the ratio of male to female was 1:8.37.The average age was 29 years old (range 9 ～83 years).Detailed clinical information was available for 1172 cases,and the main clinical manifestations included abdominal discomfort (n=526,44.88％),medical check-up (n=464,39.59％),abdominal mass (n=131,11.18％).Laboratory and imaging tests were non-specific.The tumors size was 1.3～ 30 cm with a mean value of 7.84 cm.Four handreds and seven (36.8％) cases were located in pancreatic head,96 (8.7％)were in pancreas neck and 587 (53.1％) were in the body and tail of pancreas.Eleven handreds and sixteen patients received treatment,and the resection rate was 99.2％ (n =1107).Pathological examination showed that 628(57.0％) cases were benign and 306 (27.8％) were presented as malignant behavior,mainly as infiltrative growth and invasion of the surrounding organs,vessels.Nine handreds and seventy-seven cases were followed up (ranging from 1 month to 13 years),and re-occurrence or metastasis were detected in 42 cases (4.3％) and 24 patients died.Conclusions Solid pseudopapillary tumor of pancreas is a rare pancreatic tumor with low-grade malignant potential,and part of this tumor may present as malignant behavior and it primarily affects young females.No characteristics in clinical manifestations,laboratory and imaging tests are found.Pathological examination can confirm the diagnosis.Surgical resection is the therapy of choice and the prognosis is good.

Objective To explore the strategy and outcomes of surgical treatment of thoracic ossification of ligamentum flavum(OLF),especially combined with ossification of posterior longitudinal ligament,thoracic kyphosis and epidural adhesion.Methods Fifty-three cases of thoracic OLF from January 2003 to December 2009 were reviewed retrospectively.All patients were treated by the methods of en bloc resection of semi-facet and lamina.All patients were followed up for more than half an year,including 32 males and 21 females,aged from 43 to 73 years(average 54.7 years).The lesions located in upper thoracic for 18 patients,and in thoracolumbar for 35 patients.For multi-level or jumping OLF patients,the responsible levels were determined by combination of images and clinical symptoms.For multi-level OLF with ossification of posterior longitudinal ligament(OPLL)or thoracic kyphosis(＞50°),multi-level pedicle screw fixation and correction of kyphosis were performed.For dural adhesion patients,part of cerebrospinal fluid was released with a caudal incision of dural sac resulting in collapse and epidural arachnoid separation.Ossific and adhesion dura mater were removed with integrity of arachnoid.The surgical outcomes were evaluated with preoperative and postoperative thoracic Japanese Orthopaedic Association(JOA)score,Nurick grade and neurologic functional recovery ratio.Results Fifty-three cases were followed up for 6 months to 6 years,with an average of 18 months.The average preoperative JOA score was 4.3±2.3,which significantly increased to 8.3±1.8 after operation.Postoperative neurologic functional recovery rates were 11% to 80%(average 65.8%),including excellent in 18 cases,good in 20,fair in 10,and poor in 5.The excellent or good rate was 71.7%.The mean preoperative Nurick grade was 3.7(2-5 grade)and decreased to 2.3 grade after operation.Conclusion En bloc resection of semi-facet and lamina is a safe and effective method for treatment of thoracic OLF.For the patients with OPLL or kyphosis,pedicle screws fixation and kyphosis correction was beneficial for recovery of neurologic function of thoracic OLF patients.

AIM: Through studying the differences between wild-type acidic fibroblast growth factor (waFGF) with recombinant aFGF (raFGF), the biological effect of raFGF concerned with mitogenic activity was evaluated. METHODS: NIH3T3 cell line was used. Cell proliferation with MTT method was used to study the mitogenic activity. Flow cytometry was also used for detection of apoptosis, cell membrane permeability and mitochondria potential. The role of heparin sulfate (HS) on aFGF biological effect was studied at the same time in this research. RESULTS: The enhancement of raFGF on cell proliferation was significantly lower than that of waFGF. The restriction of raFGF on apoptosis and the enhancement of it on cell membrane permeability were all lower than those of waFGF significantly. The enhancement of raFGF on mitochondria potential was lower than that of waFGF significantly. The HS improved the biological effect of aFGF. CONCLUSION: The mitogenic activity of raFGF is lower than that of waFGF and raFGF has little effect on apoptosis.

Objective To investigate the in vitro anti-candidal activity of the essential oil of Illicium verum (EOIV) alone and in combination with fluconazole. Methods The minimum inhibitory concentration (MIC) and the minimum fungicidal concentration (MFC) of EOIV were determined in 130 clinically isolated Candida strains by NCCLS-M27-A microdilution method, and fluconazole was used as positive control. Meanwhile the checkerboard microdilution method was applied to assay the combined effect of EOIV and fluconazole in 18 candidal strains. Results For the 18 candidal strains the MICs and the MFCs of EOIV were 1 517.16 ?g/mL and 2 248.55 ?g/mL for C. albicans, 1 169.24 ?g/mL and 2 338.49 ?g/mL for C. glabrata, 1 320.03 ?g/mL and 1 741.79 ?g/mL for C. parapsilosis, 1 203.50 ?g/mL and 2 407.01 ?g/mL for C. tropicalis, 1 516.32 ?g/mL and 2 144.40 ?g/mL for C. krusei, and 1 072.64 ?g/mL and 2 144.40 ?g/mL for C. guilliermondii, respectively. Significant synergistic and additive effects were observed after the combination of EOIV with fluconazole, and no antagonism was found. There was no significant difference in the mean fractional inhibitory concentration index (FICI) between the fluconazole-susceptible and the fluconazole-resistant candidal strains (P = 0.671). Conclusion EOIV has antifungal effects on medically important Candida spp.. The combination of EOIV with fluconazole presents a synergistic and additive effects.